title: Personal awareness and behavioural choices on having a stoma: a qualitative metasynthesis.
abstract: OBJECTIVE
  To answer how personal awareness and behavioural choices on having a stoma have been described and interpreted in previous qualitative studies.
  
  
  BACKGROUND
  Over the past two decades, there has been an accumulation of the qualitative studies concerning the experiences of individuals living with a stoma. Synthesising the findings of these studies would be able to improve the understanding among health providers.
  
  
  METHODS
  Qualitative metasynthesis.
  
  
  METHODS
  The literature was obtained through searching CINAHL and PubMed databases for papers published in English, and China National Knowledge Infrastructure database for papers published in Chinese from 1990-March 2012. Sixteen articles were selected using the predefined criteria.
  
  
  RESULTS
  Three themes about personal awareness and behavioural choices on having a stoma were identified: altered self, restricted life and overcoming restrictions. The results showed the impacts of having a stoma through the analysis on connections between personal awareness and behavioural choices.
  
  
  CONCLUSIONS
  Having a stoma means that the individuals have to learn to be aware of and accustomed to changes and restrictions in their everyday lives. The individuals take behavioural efforts to overcome these restrictions involving: deciding on whether to reveal or conceal their stomas to others based on the possibility of being accepted or rejected, using internal resources, seeking and receiving external supports.
  
  
  CONCLUSIONS
  The description and interpretation on personal awareness and behavioural choices associated with having a stoma is useful for nurses in providing practical, informational and emotional supports to help the individuals successfully adapt to their lives with a stoma.
authors.affiliation: Faculty of Nursing, Prince of Songkla University, Hat Yai, Thailand; Lecturer, School of Nursing, Kunming Medical University, Kunming, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Tao
authors.forename: Praneed
authors.initials: P
authors.lastname: Songwathana
authors.forename: Sang-Arun
authors.initials: SA
authors.lastname: Isaramalai
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000223:Adaptation, Psychological; D002755:Choice Behavior; D015438:Health Behavior; D006801:Humans; D036301:Qualitative Research; D012649:Self Concept; D054047:Surgical Stomas
keywords: awareness; behavioural choice; experience; qualitative metasynthesis; stoma; stoma care